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A recent study published in Complementary and Alternative Medicine (1) looked into the effect of fasting and diet on patients with rheumatoid arthritis (RA) and fibromyalgia (FM), and produced some interesting results. The investigation was carried out at an integrative medicine hospital in Germany, comparing the effects of a mostly vegetarian modified whole grain Mediterranean diet with a supervised modified fast of eight days on a small patient group. The researchers aimed to evaluate whether the Mediterranean diet or the 8-day fasting period were associated with changes in faecal flora, and whether changes in faecal flora might be associated with clinical improvements in the two diseases.
Although fasting is normally considered to be a period of consuming only water, the patients on the 8-day "modified fast" received free amounts of tea, 200 cl of fruit juice and small standardised quantities of light vegetable soup with a total maximum energy intake of 1255 kj (300 kcal)/day. Stool samples were sent for analysis of pH, mycology, bacteria and secretory IgA (sIgA) levels on admission to hospital, on the last day in hospital and at follow up after 3 months. There were no significant differences between the two groups, and "the results of this study do not suggest any relationship between diet, faecal culture analysis, sIgA and disease activity in patients with RA and FM" [The reason given was suggested to be due to the method of analysis used (quantitative stool culture), rather than gas-liquid chromatography, which had shown differences between omnivorous and vegan diets in a previous study(2)].
The results do however suggest that "the efficacy of fasting in the treatment of FM should be addressed in randomised trials, given that the clinical course in both, patients with FM and RA, appeared to be beneficially affected by fasting". The benefit was more apparent in the patients with RA (a result consistent with previous randomised trials). The authors point to specific effects of fasting on neuroendocrine regulation, central serotonin availability and quality of sleep from previous studies, but do not mention an obvious connection with fasting: it dramatically reduces the patient's lectin intake, when compared with a high lectin (Mediterranean = whole grain) diet. Additionally the study did not mention the blood group or secretor status of the patients, which can significantly alter levels of bacterial flora and sIgA.
For further information, see the book Arthritis - Fight it with the Blood Type Diet, by Dr. Peter D'Adamo
(1) Michalsen A, Riegert M, Ludtke R, et. al. Mediterranean diet or extended fasting's influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study.
BMC Complement Altern Med. 2005 Dec 22;5:22.
(2) Peltonen R, Ling WH, Hanninen O, Eerola E: An uncooked vegan diet shifts the profile of human fecal microflora: computerized analysis of direct stool sample gas-liquid chromatography profiles of bacterial cellular fatty acids.
Appl Environ Microbiol 1992, 58(11):3660-3666. Pubmed 
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